Dr Krishnaveni Nayini

Causes of Female Infertility

Infertility is not being able to get pregnant despite having frequent, unprotected sex for at least a year. If you and your partner are struggling to have a baby, then you are not alone, infertility affects 15% of couples worldwide.

What causes infertility?

Infertility can affect both the male and the female partner. Some causes of female infertility can be:

  • Ovulation disorders These can affect the release of eggs from the ovaries. Such disorders can be caused due to hormonal issues, eating disorders, tumors, or unregulated excessive exercise.
  • Polycystic ovarian syndrome: This can be caused due to various metabolic factors. In this ovulation is affected.
  • Uterine or cervical abnormalities: These can include polyps or noncancerous tumors in the uterine walls at times the shape of the uterus may also be altered which can result in infertility.
  • Abnormality or blockage of the fallopian tube (the tube which carries the ovum to the uterus): Infections are usual causes of inflammation in the fallopian tube. This can lead to blockage of the tube resulting in an inability to conceive successfully.
  • Thyroid problems: An overactive or underactive thyroid gland can lead to a hormonal imbalance.
  • Early menopause- At times ovaries may stop working and menstruation may stop before the woman hits 40, leading to infertility. Many causes can attribute to it including genetic, hormonal, and cancer therapy.

Other causes of infertility in a woman can include pelvic adhesions and cancers.

Factors that can put a woman at risk of infertility

Various factors can lead to infertility in a woman. However, women with certain risk factors are more likely to have it. Some risk factors include:

  • Age: Fertility of women decreases gradually with time. Women are most fertile in early ages and their fertility gradually reduces with time, which is more after their mid-30s. The quality and quantity of ova or eggs reduce with time thereby leading to problems related to infertility.
  • Tobacco: Smoking has an ill effect on both fertility and the possible effectiveness of fertility treatment. Miscarriages are also seen more frequently in women who smoke.
  • Alcohol: If a woman consumes alcohol while trying to conceive then it can have an ill effect on fertility.
  • Problem with weight: Being both overweight and underweight can affect fertility. Amongst Indian women, an inactive lifestyle and being overweight may increase the risk of infertility, similarly eating disorders and anorexia can also affect the chances of a woman conceiving. A healthy diet along with adequate exercise and physical activity is always recommended for women to stay healthy.
  • Exercise issues: Just like weight, maintaining healthy levels of exercise is important. No exercise and indulgence in overly strenuous exercise both can lead to problems related to fertility.
  • Exposure to chemicals: Some pesticides and metals, such as lead, and solvents have been linked to fertility problems in both men and women. Women involved in work that exposes them to an unsafe amount of these chemicals can have fertility issues.
  • Stress: One of the major causes of most health problems is stress. Stress can affect healthy ovulation in women and it can also reduce sexual activity altogether.


When should you meet a doctor?

If you have not been able to conceive for one year despite frequent unprotected sex then you should talk to your doctor about it. However, meet your doctor earlier in case:

  • Your age is 35 or above and you have been trying to conceive for more than 6 months
  • You are over 40 years of age
  • Your periods are irregular or absent
  • Your periods are very painful
  • You have been diagnosed with any uterine or pelvic problems
  • You have had multiple miscarriages in the past
  • You have PCOS
  • You have any other known fertility issue

What to expect when you visit a gynaecologist?

Your doctor will first collect medical and sexual history from both the partners in detail, after this initial evaluation specific tests such as tubal evaluation or ovarian reserve testing will be done to find the cause.

The treatment aspects for infertility depend upon the cause and can range from simple medications to in-vitro fertilisation. Below are some techniques that may be used by your gynaecologist:

Laparoscopy: Ovarian cysts, endometriosis, blockage in the fallopian tube, etc can be removed through laparoscopy. Removal of such specific causes can increase fertility.

Hysteroscopy: Here a hysteroscope is used to look inside the uterus.  This method too can be used to remove polyps or specific blocks that are reasons for infertility.

Medication: Prescription of drugs in the form of hormonal therapy or specific drugs for the treatment of diseases such as sexually transmitted diseases can help cure inflammation and increase ovulation for increased fertility. PCOS may require one to consume medicines to lower the blood sugar level and enhance metabolism.

Intrauterine insemination: In this, the sperm is placed into the uterus directly. This procedure is done when a woman is ovulating or is on specific medicines to increase her chances to ovulate.

In vitro fertilization (IVF): In this technique, the sperm and ova are taken and fertilised outside the human body in a dish. The fertilised embryo is then implanted in the uterus.

Egg donation:  At times a woman may be unable to conceive because of a problem in the quality and quantity of her eggs which may not improve. In such a case eggs from an ovary of a donor are taken, fertilised, and implanted into the uterus.

Infertility is a common problem that can affect multiple couples. The key to finding the best solution is getting in touch with your gynaecologist at the earliest.

Dr. Krishnaveni Nayini has vast experience of over two decades in treating infertility. She is a senior obstetrician and gynaecologist practicing in Hyderabad, India.